Whatever the reason, Americans are visiting their doctors less frequently.
A report released this week by the U.S. Census Bureau revealed that working-age adults made an average of less than four visits to doctors, nurses, dentists or other medical providers in 2010. That's down from nearly five visits they made in 2001.
"This is mostly related to economics," said Dr. Tom Yetman, chief executive officer for Providence Medical Group in Everett. "People are nervous about seeking health care. Many don't know what their medical insurance will pay. Their co-pays and deductibles are higher because companies are asking their employees to shoulder more of the responsibility. And people believe that taking time off to see the doctor puts their jobs at risk."
According to the census report, most Americans consider themselves to be healthy.
"I do not think that we are healthier now than in 2001," Yetman said. "In the Puget Sound region, people are pretty healthy. But as a nation, we're more obese, more have diabetes and heart disease and kids have less P.E. in school."
About 24 percent reported to the Census Bureau that their health was "good," while 8 percent described it as "fair" and 2 percent as "poor." That nearly 66 percent said their health was either "excellent" or "very good" is partially wishful thinking, Yetman said.
"No news is often interpreted as good news. What we hope for is what we say we believe," Yetman said. "Of those people, I wonder if their primary care physicians would support their claims. A portion of our population is taking better care of themselves, but not most."
The decline in the use of medical services was widespread, taking place regardless of health status, said Brett O'Hara, chief of the Census Bureau's health and disability statistics branch.
Among all people who reported excellent health, 85 percent were insured. The number of Americans without health insurance rose to nearly 50 million in 2010, up about a million people from the year before, according to the Census Bureau.
Among uninsured adults who visited a doctor or dentist during the year, 13 percent visited an emergency room, while 20 percent to 30 percent received free or discounted services, such as the services provided by Safe Harbor Free Clinic in Stanwood and the Community Health Center of Snohomish County in Edmonds.
"It's getting really tough out their for a lot of people. Our patient load is still going up," said Julie Vess, executive director for Safe Harbor. "In our exit interviews with patients, we ask where they would go if Safe Harbor wasn't open. Most say nowhere. Many people who come to our chronic care clinic on Fridays haven't been to a doctor for four or five years."
Yetman said many people are ashamed to ask for help. Medical centers such as Providence are trying to provide services on sliding fee scales and offer appointments on weekends and evenings.
"The problem is that when people avoid care, their health gets worse and ends up costing even more," Yetman said.
Bruce Williams, a physician with Swedish/Edmonds Medical Center, said that, with some diseases, people who don't get regular check-ups don't even know they are sick.
Doctor visits were more likely as people got older, the report said. About 37 percent of people age 18 to 24 did not visit a health care provider at all during the year. Of those 65 and older, only 8 percent did not visit their doctors.
Hispanics were the least likely racial or ethnic group to see a medical provider with 42 percent never visiting a doctor during the year. Women were more likely than men to have visited a medical provider during the year: 78 percent compared with 67 percent.
More than half the population did not take prescription medication at any point during the previous year, while 35 percent reported taking it regularly -- 80 percent of older adults and 13 percent of children, for example.
Respondents also were much less likely to visit a dentist at least once in the last year than they were a medical doctor.
"I do think more people are taking their health seriously and that those who don't are in a minority, but the stress of our society is great," Williams said. "South Snohomish County ranks higher than state averages in binge drinking and depression. It's tough to raise kids with both parents working or nobody working."
Gale Fiege: 425-339-3427; firstname.lastname@example.org.
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